Catatonic schizophrenia is one feature of a serious mental illness called schizophrenia. Schizophrenia prevents you from separating what’s real from what’s not, a state of mind called psychosis.
Catatonic schizophrenia affects the way you move in extreme ways. You might stay totally still and mute. Or you might get hyperactive for no reason. The new name for this condition is schizophrenia with catatonic features or schizophrenia with catatonia.
Symptoms
Catatonia can show up in many different ways. A core sign is that you don’t move normally, even though you are physically able.
Common symptoms include:
- Not moving
- Not talking
- Sluggish response
- Staring
- Parroting someone’s movements or speech over and over
- Tapping feet or other repeated movements
Diagnosis
Catatonic schizophrenia is no longer a stand-alone diagnosis. Catatonic symptoms can happen not only with schizophrenia, but in mood disorders, autism, and other conditions. But it most often shows up with schizophrenia.
Your doctor may tell you that you have catatonia, or catatonic schizophrenia, if you have at least three of these 12 features. You:
- Stay mute
- Are unmoving or react very little to what’s happening around you (stupor)
- Make odd gestures or movements (mannerisms)
- Passively let others position your limbs or other body parts
- Ignore instructions or requests
- Are agitated or hyperactive for no reason
- Hold your leg up or keep other uncomfortable positions for a long time (posturing)
- Stay locked in an awkward position for a long time and resist attempts to move you (waxy flexibility)
- Mimic someone else’s movements (echopraxia)
- Mimic someone else’s speech (echolalia)
- Repeat senseless gestures like rocking, shrugging, and waving (stereotypy)
- Contort your face into a grimace
Causes
We don’t know what exactly triggers catatonia. Researchers have found that people with these symptoms have unusual activity in parts of the brain like the forebrain and hypothalamus that govern body movement.
The illness usually starts in your late teens or young adulthood. It is a lifelong condition. But the right treatment will help ease your symptoms.
If you have a family history of schizophrenia, you are more likely to have the condition, too. Also, drugs and alcohol can cause catatonic symptoms in some people with schizophrenia. The same is true for certain antipsychotic drugs or other medications you may take to treat an underlying mental disorder.
Treatment
Medications can be very effective in easing catatonic symptoms. They’re the first option for treating catatonia. Specifically, a class of anti-anxiety drugs called benzodiazepines, or “benzos,” along with ECT, is considered the first-line treatment for catatonic symptoms. Your doctor may prescribe:
- Alprazolam (Xanax), an anti-anxiety drug
- Lorazepam (Ativan, Lorazepam Intensol), used to treat epilepsy and anxiety
You might take benzodiazepines by mouth or through an IV line. Your doctor may also prescribe other drugs, such as memantine or lithium, if they are right for you.
Brain stimulation. This treatment uses either electrical currents or magnetic pulses.
- Electroconvulsive therapy (ECT). This can lower your symptoms by half or even get rid of them altogether. Your doctor may recommend it if medications haven’t helped. ECT uses short bursts of electric current that go through a cap on your head to reach your brain. The treatment can leave you with confusion and temporary memory loss.
- Transcranial magnetic stimulation (TMS). You wear a device on your head that sends out a magnetic pulse to activate nerve cells in your brain. TMS can target specific regions of your brain better than ECT can. It also causes fewer thinking and memory problems. But TMS is newer than ECT, and it’s not as clear how well it works.
Hospitalization
If your catatonic symptoms are severe, you may need to be hospitalized for a while. This decision will be based on your safety. Catatonic symptoms sometimes can disrupt your heart rate, temperature, and blood pressure. You can leave the hospital once your symptoms are under control and you have a long-term treatment plan in place.
